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Mindi's daughter was taken by authorities after Mindi had a mental health crisis. Mindi has never been able to get her daughter back, even though she's now capably raising a son. (Steve Herbert for ProPublica)

Should a mental illness mean you lose your kid?

Citing "predictive neglect," Missouri and myriad other states are terminating parents' connection to their children

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June 1, 2014 4:00AM (UTC)

In August 2009, Mindi, a 25-year-old struggling new parent, experienced what doctors later concluded was a psychotic episode. She had been staying in a cousin's spare basement room in De Soto, Kansas, while trying get on her feet after an unexpected pregnancy and an abusive relationship. She'd been depressed since her daughter was born and was becoming increasingly distrustful of her relatives.

Isolated, broke and scared, one Saturday morning, she cracked. She woke to change her 5-month-old daughter's diaper. When Mindi looked down, she believed the baby's genitals had been torn.

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Mindi's mind raced for an explanation. The one she came to? That her baby had been raped the night before; that someone—she did not know who—had put sedatives in the air vents.

Mindi called her pediatrician's office. A receptionist told her to take her daughter to a children's hospital in nearby in Kansas City, Missouri. Doctors there found no evidence that the girl had been harmed or that any of what Mindi claimed had actually happened.

After Mindi started arguing, medical staff sent her for a psychological evaluation and notified local child welfare authorities, according to court records. (As is typical in child welfare cases, the court documents do not include the full names of anybody in the family. Mindi has asked ProPublica to use only her first name, as did other parents in the story.)

That night, authorities took emergency custody of Mindi's daughter, who is referred to in court documents by her initials, Q.A.H. A court-appointed doctor later concluded that Mindi had experienced postpartum psychosis.

But Mindi rebounded after the episode. She began to attend therapy and to see a psychiatrist, who prescribed an antidepressant. She found a job as a shift manager at Kmart and moved into her own apartment. Each morning, she'd call the foster home where her daughter had been placed and she'd read Q.A.H. a book.

In time, her psychiatrist, therapist and even a panel of judges concluded that Mindi should get her daughter back.

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"I found the help I needed to be healthy," says Mindi, a wide-eyed woman with a round face and a chatty affect. "I was dealing with some mental battles at the time."

Dr. Stanley Golan, the psychiatrist who treated Mindi, diagnosed her with a mix of post-traumatic stress disorder—likely, a therapist later said, related to abuse—depression and possibly a kind of "mild delusional disorder." Still, the diagnoses, Golan said in court testimony, "do not interfere with her parenting and she is able to adequately care for Q.A.H."

"You can have these diagnoses and be symptom-free," he testified.

Indeed, in September 2011, Mindi, who was in another relationship, gave birth again, to a boy named Jace, whom she's now raising capably on her own. Citing Mindi's pending case over Q.A.H., Kansas authorities took Jace at birth and placed him in foster care. But they soon returned him after finding no evidence that Mindi posed any risk to her son. As a family therapist testified, Mindi has provided a "nurturing, loving environment and had met all of [Jace's] needs."

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Yet four years later, after a protracted series of court fights, Mindi does not have her daughter back.

"I couldn't see how they could keep one while I had the other," said Mindi, sitting on the carpet in a living room with her son, surrounded by toy trains and a pile of books. "I don't think I should have to fight for my own child to come home." (Missouri and county child welfare officials declined to discuss the case.)

The question in Mindi's case is not about what authorities did when she plunged into a mental health crisis—nearly everyone involved in the case, including Mindi's own attorneys, agrees it was likely appropriate to remove her baby that day. Instead, the issue is whether a mental health diagnosis itself, in the absence of any harm, should be enough to keep Mindi from ever getting her daughter back.

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Under a concept sometimes called "predictive neglect," Missouri and about 30 other states allow courts to terminate a parent's connection to a child if authorities conclude a mother or father has a mental illness that renders them incapable of safely raising the child. Officials usually must present evidence that the illness poses a threat. Most cases involve significant mental illness, not run-of-the-mill depression or anxiety. Yet there need be no evidence of actual harm or neglect, just a conclusion that there is a risk of it.

States typically do not track how many parental termination cases are related to mental illness, or how often parents have lost children based on a diagnosis. New York, one of the few states that does tally such cases, has about 200 parental terminations annually based on mental disability, a category that includes both mental illness and "mental retardation." If there were a similar rate nationally, that would amount to several thousand cases per year. The cases are typically sealed, and there's no way to know how many involve court overreach.

But if it's impossible to know how many parents lose children unnecessarily because of the stigma of mental illness, it's clear that the process for deciding such cases is deeply flawed.

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Courts' decisions rest on the recommendations of evaluators who often do not observe parents at home or examine their actual record of parenting. Instead, they rely on psychological tests and case notes.

Incomplete evaluations are an "endemic problem," said Joanne Nicholson, who directed a unit that conducted parenting assessments for Massachusetts child welfare agencies and is one the country's leading researchers on parents with mental illness.

"Parents are often evaluated without a real analysis of their supports, of the life they actually live," said Nicholson, currently a psychiatry professor at Dartmouth College. As a result, "the diagnosis starts to speak louder than real life."

Children can also pay a price when courts overstep. Research shows that forcing children in and out of different homes can leave lasting emotional scars.

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The logic of removing kids from parents with serious mental illness is straightforward. Studies have shown that serious mental illness correlates with higher rates of child neglect and abuse. Parents who can't take care of themselves aren't going to be in a position to take care of a child. And delusional thinking can lead to irrational, dangerous behavior.

"You have to put protection first," said Mary Kay O'Malley, who worked for years as a foster care caseworker, is now a professor at the University of Missouri Law School and has dealt with many cases like Mindi's.

When officials fail to intervene to protect children from mentally ill parents, the results can be tragic, irrevocable and front-page news. In one notorious 2008 case, a Long Island, New York, mother drowned her three children after county officials failed to respond to repeated warnings from relatives that she was dangerously unstable.

But O'Malley says she's seen agencies and courts unnecessarily cut off parents from their children. She says that's what happened to Mindi.

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Six months after Mindi brought her daughter to the hospital, in February 2010, a parenting counselor reported that Mindi "is ready to be there for [Q.A.H.] emotionally, mentally, and [she] can support Q.A.H."

"The parent changed in this case," said O'Malley, who consulted for Mindi's attorneys for free after learning about the case. "But the court didn't."

The laws permitting termination of parental rights were mostly written in an era when serious mental illness was assumed to disqualify patients from participation in normal life, including parenting. Parents like Mindi may have been institutionalized. In many states, the mentally ill or intellectually disabled could be sterilized. The phrasing in the law has often changed—states have removed words like "feebleminded" and "depravity"—but the same concepts echo.

Indeed, a 2012 presidential commission report found that "parents with psychiatric disabilities experience the most significant discrimination when they attempt to exercise their fundamental right to create and maintain families."

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"When [mentally disabled] people were institutionalized, they could not keep their kids. Now they're living on their own, and they're not allowed to keep their kids," said Patrick Yewell, who recently retired from a career as a foster care caseworker, supervisor and administrator in Kentucky's child welfare system.

Rudy, a 42-year-old West Indian-born man in the Bronx, New York, was also denied custody of his daughter. His chance to raise her now rests largely on a psychiatrist's evaluation consisting of two visits and a review of Rudy's records.

Rudy has long struggled with chronic bipolar disorder, for which he has been repeatedly hospitalized. Rudy is also intellectually delayed—an IQ test placed him at the borderline of intellectual disability.

He has no history of violence, abuse or neglect. His only child, J, who is now 3, was removed from the hospital immediately after she was born and placed in foster care. Rudy has been asking to be allowed to raise his daughter with help from his mother and sister.

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Authorities first took J because of significant concerns about her mother. J's mother, from whom Rudy had separated before J was born, had already lost three other children to foster care. One of the children removed from J's mother and placed in foster care later died at the hands of a relative of J's mother. And like Rudy, J's mother suffers from mental illness and intellectual delays.

On June 28, 2010, Rudy watched as two Nassau County caseworkers and a cop walked out of the hospital with 4-day-old J. (ProPublica confirmed details of the case through court documents and multiple interviews.)

Rudy, who has closely cut hair and often dresses in baggy sports jerseys, recalls the day his daughter was taken as the saddest of his life. "I asked them why they took my daughter, and they didn't respond," Rudy remembered in a soft stuttering voice with an accent left over from his childhood in St. Croix. "I asked them if I could hold her before they took her, and they wouldn't let me hold her."

Rudy began what would become a weekly ritual: Riding two trains and a bus every Tuesday from the Bronx to Long Island to spend 75 minutes with J in a room in the county child welfare office. Some caseworkers were suspicious of Rudy. "The major concern for the family is both parents' mental health issues," child welfare officials wrote in a court document.

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Others described him as a loving, if inexperienced, father. One caseworker note from a visit in September 2011 described Rudy as "gentle and caring," rocking J to sleep on the couch at the county office.⁠ Two weeks later, a different worker wrote that he was "getting more adept at caring for the child."⁠ J's mother, meanwhile, stopped showing up for visits and failed to appear in court.

But just over a year after J was first placed in foster care, two Nassau County officials pulled Rudy into a meeting room after a visit with J and told him that the county planned for J to be adopted by her foster family, case documents show.

"They said I have a mental illness, they were trying to see if I would sign away my rights," Rudy said as he sat one recent evening in his Bronx apartment, a pot of rice steaming on the stove. "They expected it to go smoothly, they expected me to surrender my rights."

In New York, counties are required to appoint an attorney for parents at risk of losing their kids, but Rudy hadn't yet been given one. Unsure of what was happening, Rudy went home and called his sister Rubeka, in Tampa, Florida.

"He sounded really upset. Not really angry, but more hurt," said Rubeka, who works as a psychiatric nurse.

Rudy and Rubeka consulted a lawyer and came up with a plan in which Rudy would move in with his sister and mother in Florida so they could raise J together. J's mother, who was also facing the termination of her parental rights, and whose mental health, according to case notes, was deteriorating, agreed to the plan. (J's mother declined to discuss the case with ProPublica, except to say she supported Rudy's effort to get custody.)

But Nassau County officials told Rudy that he should have laid out the plan months earlier and that because so much time had passed, federal child welfare law required them to request termination of his parental rights. The county's records suggest that caseworkers had warned Rudy about this; Rudy said he did not understand he could lose his rights so rapidly and that he waited because he believed J's mother was going to regain custody. Caseworkers also noted that visits between Rudy and J had gotten harder as she grew older—she would often cry inconsolably; she knew her father only as the man she saw on Tuesdays and considered her foster parents her real mother and father.

But these were not the reasons Nassau County authorities listed when they petitioned a county court to sever Rudy and J's legal ties. Instead, the county filed to terminate his rights based on his mental illness. Under New York law, parents can lose their children if courts decide their mental disabilities render them incapable of parenting for the "foreseeable future."

The Nassau County Department of Social Services would not respond to questions from ProPublica about the case or any related policy issues. The county referred ProPublica to the New York State Office of Children and Family Services. That office declined to comment as well and referred us back to Nassau County. The foster parents' attorney and the attorney appointed to represent J also declined to discuss the specifics of the case.

In the summer of 2012, a judge sent Rudy to Dr. Joseph Scroppo, a psychologist and attorney who has held appointments at several New York universities. Scroppo has a contract with Nassau County to perform forensic psychological evaluations and make recommendations about whether parents should keep their children.

Scroppo's evaluation was exhaustive compared with many in other parental rights cases. He met with Rudy alone for nearly 10 hours. Then Scroppo watched Rudy interact with J for 30 minutes. He gave Rudy an IQ test, asked him to define words, stack blocks and read a few sentences.⁠ He reviewed Rudy's mental health records, including his hospitalizations for manic episodes, and case notes from the child welfare department.

Scroppo concluded that Rudy could not be trusted to raise his daughter.

Rudy's "score indicates that he is probably capable of semi-independent living but would experience significant problems if he were to attempt fully independent living," Scroppo wrote. Citing Rudy's hospitalizations, Scroppo concluded that Rudy "is now, and for the foreseeable future, unable to adequately care for the subject child."

During a hearing in May 2013 in Rudy's continuing parental rights case, Rudy's lawyer, who was appointed to the case when the county filed for termination, grilled Scroppo on his evaluation.

"[But] wasn't it your understanding that [Rudy] was cooking his own meals at the time of your evaluation?" Broderick said, looking down at her notes.

"I'm not sure whether he was cooking his meals or not," Scroppo said.

"Did you inquire?" Broderick asked, looking up.

"No, I did not," he said.

"Wasn't it true at the time of your evaluation that [Rudy] was paying his bills?" she went on. "He was responsible for his own hygiene?"

"As far as I knew, yes," Scroppo said.

Broderick continued to push Scroppo to offer evidence from Rudy's life. Instead, Scroppo said, "I based the [categorization of] semi-independent status on the test that I administered to him."

New York's law allows mothers and fathers to present alternative evaluations in court, though funding is not always made available to pay for them. Rudy's sister and brother scraped together several thousand dollars to hire an evaluator for a second opinion.

Dr. Barry Rosenfeld, a psychologist who directs clinical training at Fordham University, did not just administer tests. He spoke to the people in Rudy's life to get a better sense of him—and pieced together a very different picture.

He discovered that in the early 2000s, Rudy shared an apartment near Tampa with Rubeka and their brother Mitchell. Mitchell had a baby boy and Rudy would take care of him. "My son was around 3 or 4. We'd go out for the night, or on the weekends, and Rudy worked less than us, so we'd leave my son with him," Mitchell said recently over the phone from Florida. "I never had any worries about that."

Rosenfeld learned from Norma Gonzalez, a caseworker who'd met regularly with Rudy in the apartment building where he lived when J was born, that "[Rudy] successfully manages his own day-to-day needs and has done so consistently for 3 years."

Rosenfeld noted that Rudy's plan to raise J with his sister indicated not incapacity, but a responsible recognition of his own need for help. "There appears to be no evidence that [Rudy]...is unable to adequately plan for care for his daughter," he wrote.

ProPublica asked a third party to read the two evaluations and to assess the soundness of their methods. Maurice Feldman, a psychologist based at the Centre for Applied Disability Studies at Brock University in Ontario, Canada, researches parenting capacity evaluations. He said that the two evaluators relied on different methods and assumptions.

Scroppo's evaluation didn't take into account the help Rudy planned to have from his family; Rosenfeld's did. "The first evaluator makes the assumption of the scenario that the parent has to parent the child totally independently," Feldman said.

Feldman also said that even though Scroppo's report was relatively thorough, it exhibited a common flaw: It measured mental disability in isolation from its impact on parenting.

"There is a conceptual leap that the first assessor used," Feldman said. He concluded that because Rudy scored "low on cognitive and personality disorder measures, therefore he can't parent," Feldman said. "But that is a fallacy."

"There is nothing in the first evaluator's report, none of the materials cited, that would lead me to believe he can't take care of his daughter."

Scroppo declined to speak with ProPublica about Rudy's case, citing professional obligations to confidentiality. But he did speak in broad terms about mental health evaluations in child protective cases, which make up a significant part of his practice.

"Evaluators are tasked with evaluating the specific parents, not the support system or other persons in their lives," Scroppo explained. "It's driven by the fact that only the parent is going to have ultimate decision making over the child. Although the parent may have —and I think it would matter if they did—a team to help them, it would hinge on their ability to be responsible. The law is for me to look at the parent in and of her self."

Academic studies have found that mental health parenting evaluations often take this self-sufficiency view of parenting. But as Feldman argues, "Nobody raises their child in a vacuum."

The American Psychological Association guidelines actually encourage evaluators to reach out to "extended family members and other individuals when appropriate (e.g., caretakers, grandparents, clinical and social services providers, and teachers)."

Yet often that doesn't happen. A decade ago, DePaul University researchers reviewed 190 evaluations from Chicago's child welfare system. Almost none of the evaluators called on family members or others besides the parents. Often, the evaluators relied on single short interactions with parents or failed to observe them with their children. More recent studies by researchers in New York and at the University of California, Berkeley found similar patterns.

"The tests are already less than perfect at measuring what they were designed to measure—IQ or psychopathology—and they are far less than perfect at measuring parenting," Karen Budd, the DePaul report's lead researcher, told ProPublica.

One reason evaluations come up short is money, said Nicholson, the Dartmouth psychiatry professor who researches parents with mental illness. "Really thorough evaluation is pretty resource-intensive, and nobody wants to do them," Nicholson said. "Nobody can actually afford that. Or they say they can't. Taking a kid away is expensive, too."

Even Scroppo agrees that these cases can be hard calls: "The severity of the mental illness is important in making any determination. And sometimes the line is not clear."

When Rudy is well, he is soft-spoken and thoughtful. "I am really focusing on being a father to my daughter. My dad was a good dad—he worked hard, he took care of us, and I want to do the same thing for my daughter," Rudy said last fall, after returning from work at the grocery store where he stocked shelves.

He also knows he would likely struggle to raise J by himself. Rudy has bouts of numbing depression and high-paced mania. At their worst, Rudy's manic states can flare into delusions. He has believed that he's a businessman and that YouTube videos carry secret messages. The last time he was hospitalized was in the winter of 2013. He and his sister Rubeka say the stress of the case, and the threat of losing his daughter, finally overwhelmed him.

But raising J alone, of course, hasn't been the plan. "If he slipped into an episode, we would know it," Rubeka says. "We would have been there to support her together."

Rudy acknowledges there are no easy answers nor perfect endings. The case has now dragged on for nearly four years. And more hearings are scheduled for June in the Nassau County family court.

J has "been in foster care for a long time," Rudy said. "It will be hard to take her out of foster care. [The Department of Social Services] is saying that she bonded with the foster mom. It's a tough case, you know."

When authorities take a child, a 1997 federal law mandates that they must provide parents with access to the programs and services they need to reunite with their children. If the issue that brought a child into foster care is homelessness, child welfare systems must find parents housing. If it's drugs: treatment. If it's abuse: parenting classes. Parents can be compelled to attend anger management classes, seek counseling or leave an abusive partner.

But the law does not explicitly cover disabilities, mental or physical. And in the absence of a clearly applicable federal standard, at least five states—Alaska, Arizona, California, Kentucky and North Dakota—have listed mental illness as one of a few "aggravating circumstances" that exempt authorities from having to provide help to attempt to piece families back together. Among the handful of other circumstances? Murdering, torturing or sexually abusing a child.

In New York, courts can relieve child welfare departments of having to prove they have made efforts to reunify families if judges deem a mother or father too mentally disabled to parent. That has been Nassau County's position regarding Rudy. "The department is not under any obligation to make reasonable efforts to return the child and to make recommendations [for services] to him," the county's lawyer said in a November 2013 hearing.

The rationale for denying services is often explained this way: If a parent is indeed so mentally ill that they're never going to be able to safely raise a child, why drag that family through an extended legal case and compel taxpayers to make futile expenditures?

But without setting up supports and services, there may be very little way to know whether a parent can raise a child. Rudy was not offered parenting classes or help moving to an apartment where J could join him. No caseworker tried to help Rudy find a program that could support him to raise his daughter, though supportive-parenting programs exist in New York City.

"Nobody ever offered me any help," Rudy says.

In Missouri, where Mindi's case unfolded, the state's obligation to explore support for mentally ill parents has become an issue in the courts.

In 2012, a state appellate court reversed a termination based largely on the testimony of a psychologist who'd administered tests but never actually observed the mother with her child.

"Even a mental condition that renders a parent unable to provide adequate care for a child alone does not provide a basis for termination if the parent has access to additional support because parenting is frequently 'a group effort,' " the appeals court wrote. "It is because of the frequently group nature of modern parenting that [the law] does not allow for the termination of parental rights simply because a parent cannot shoulder the entire burden of raising a child on his or her own."

While ProPublica spoke to dozens of attorneys around the country about questionable cases, few termination cases are appealed and fewer still are reversed—higher courts are typically deferential to trial court decisions. Missouri appeals courts and the state's Supreme Court have overturned at least seven other mental-health-based terminations since 2000. We found another seven cases since 2000 in which New York appellate courts overturned mental disability terminations.

In the last decade, states including Idaho, Utah and Vermont have added language to their child welfare statutes to protect parents with disabilities, including psychiatric disabilities. "A court may not remove a child from the parent's or guardian's custody on the basis of...mental illness," the Utah law reads.

But mental health advocates say progress is too slow. They say that even in states where mental illness is not listed explicitly as a reason for terminating parental rights, parents still face bias and aren't getting the help they need.

"People have focused on the language of disability or mental illness in the laws, and that is important," said Jennifer Mathis, deputy legal director of the Bazelon Center, a mental health advocacy groups. "But you also need to provide supports."

In 2011, two years after Mindi's child was removed, Missouri's legislature adjusted the child welfare laws to recognize the rights of disabled parents. The change came after news broke of a blind couple whose baby had been removed over concerns that their disabilities impaired their ability to raise a child.

The measure affirmed that nothing in the state's laws should "be construed to permit discrimination on the basis of disability or disease." Children cannot be removed, nor can parental rights be terminated, the bill maintained, "without a specific showing that there is a causal relation between the disability or disease and harm to the child."

As it was originally introduced, the Missouri legislation noted that in making child removal and parental termination decisions, the state "shall consider the availability and use of accommodations for the disability or disease, including assistive technology and support services." That language—the sort that advocates for parents and for people with psychiatric diagnoses say is needed to stop unnecessary family separations—was removed from the final legislation.

In Mindi's case, her daughter's foster parents and the state of Missouri asked the judge in 2011 to terminate Mindi's parental rights and for Q.A.H. to be adopted. The reason her rights should be terminated? Citing state law, lawyers for Q.A.H.'s foster family wrote that Mindi has "a mental condition which is shown by competent evidence either to be permanent or such that there is no reasonable likelihood that the condition can be reversed."

The petition rested largely on reports of the event three years earlier, when, after the delusion about her daughter's rape, Mindi brought her daughter to the hospital.

In 2012, a Missouri trial court granted the petition to terminate Mindi's parental rights, formally severing her connection to Q.A.H. Mindi was "unable to knowingly provide [Q.A.H.] the necessary care, custody, and control" because, the judge wrote, she "has delusions that then become her reality."

Earlier in the case, Mindi had regained custody of Q.A.H. after eight months of separation only to lose it again after refusing to allow visits from Q.A.H.'s father, who Mindi says was abusive. Such lack of cooperation is not legally sufficient to permanently separate children from their parents, but the judge who terminated Mindi's parental rights chalked up her claim of abuse to ongoing delusions—though no evidence was presented on this, one way or the other. Q.A.H. was placed back in foster care, this time with a new couple.

The judge also said in his opinion that Mindi had made strange faces while sitting in court, an "affect," the judge wrote, which "is quite unusual in termination of parental rights proceeding, but is consistent with mental health diagnosis given by [the court-appointed psychiatrist]."

Mindi's lawyers and other attorneys who represent parents like her say the judge's reaction is common: Actions and statements that might pass without notice in people without a mental illness are pathologized in people with a diagnoses. "People who have those records at the back of their mind are looking for something to support their theory that she's not stable," said Sandra Wirtel, Mindi's court-appointed attorney.

Mindi and her lawyers appealed the 2012 ruling, and the following year a Missouri appellate court sided with her. The trial court decision, a three-judge panel ruled, "utterly fails to establish that [Q.A.H.] would be harmed by a continued relationship with Mother."

The appellate judges added that the judge's observation of Mindi's facial expressions "does not constitute reliable and substantial evidence on the critical question of Mother's present mental condition."

Mindi began preparing for Q.A.H. to return, setting up a bedroom with a pink bedspread. They had not seen each other for nearly a year, and to rebuild their relationship, Mindi and Q.A.H. were allowed to begin visits. Her daughter was bigger, more talkative, her dark blond hair now in long curls. At first, Q.A.H. was shy, feeling out her relationship with this woman she'd been separated from. But then she asked her mother to play a game Mindi had made up when Q.A.H. was younger. "She remembered that," Mindi said.

Mindi thought her daughter would be home for Christmas. But in late 2013, Mindi's lawyer called her to tell her the case was not over. Q.A.H.'s foster parents, joined by the state, had appealed the case to the Missouri Supreme Court. Visits were halted again. The judges heard arguments in the case two months ago.

When she's with her son, Mindi can, for a moment, forget that for the last three years her life has been consumed by the fight for her daughter. Mindi enrolled in college again. She spends a lot of time at her Baptist church—Wednesday night Bible study and Sunday services. She now lives in the home of a family friend who is mostly away—Mindi's father died when she was young and she's estranged from her mother.

Late last year, she started to meet with the foster parents for monthly mediation sessions. Q.A.H. had lived with them for more than two years now.

To her attorneys, Mindi's case still seemed like a sure win. In 2007, the Missouri Supreme Court restored the parental rights of a young mother who'd been diagnosed with bipolar disorder.

Judge Richard Teitelman sits on the Supreme Court of Missouri. Speaking broadly about such cases, he told ProPublica, "given the number of people in this world who are bipolar, or have some mental illness and who raise children very effectively,it would not seem to me that it should be a status thing—that anyone can say, if you're mentally ill you can't be a parent, you can't have a child. That does not seem to comport with today's reality."

In the early afternoon of March 25, Mindi received a phone message from the lawyer appointed to represent her in her parental rights case. The news was what she feared. "I just lost my daughter," Mindi wrote in a message to ProPublica.

The Missouri Supreme Court ruled, 6-to-1, that the lower court should be granted broad discretion in making decisions about the facts of a parental termination case. Though the judges noted that the state still had an obligation to prove that a parent's mental condition poses a risk to the child, they wrote that since the trial court had believed Mindi was a danger, the Supreme Court, which did not hear testimony from witnesses, was in no position to disagree.

Judge Teitelman issued a short lone dissent. "The evidence in this case...fails to demonstrate clearly that the Mother is currently unable to adequately care for the child and that she will be unlikely to do so in the future," he wrote, adding that the court's decision had been "simply speculative."

In early May, Q.A.H.'s adoption went through. Mindi has no contact with her daughter.